American Board of Surgery Qualifying Exam (ABS QE) Practice Test

Which cancer is most commonly metastatic to the adrenal glands?

1. Liver cancer

2. Renal cancer

3. Breast cancer

4. Lung cancer

The correct answer is: Lung cancer

The adrenal glands are a common site for metastases from various primary cancers due to their rich vascular supply. Among the common malignancies, lung cancer is particularly noteworthy as a leading cause of metastasis to the adrenal glands. This is largely attributed to the high incidence and aggressive nature of lung cancer, which can disseminate hematogenously (through the bloodstream) to distant sites, including the adrenal glands. Additionally, the incidence of adrenal metastases is significantly higher in patients with advanced lung cancer compared to other cancers. While cancers such as renal, breast, and liver can also spread to the adrenal glands, studies and clinical observations indicate that lung cancer typically outpaces these other malignancies in terms of frequency and prevalence of adrenal involvement. This characteristic of lung cancer makes it crucial for clinicians to consider when evaluating patients who have known lung tumors and present with adrenal masses.